Urine Culture and Susceptibility
CPT Code(s):
87086
Turnaround Time:
48 - 72 hours
Specimen Requirements
Preferred Specimen:
Urine
Minimum Volume:
5.0 mL
Transport Container:
Yellow Top Tube or Sterile Cup
Transport Temperature:
Room Temperature
Collection Instructions:
Clean catch, mid - stream collection
Rejection Criteria:
Unrefrigerated unpreserved specimen greater than two hours old; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually more than 48 hours for urine); specimen collected from a Foley catheter bag; specimen in nonsterile or leaking container
Stability Criteria
Room Temperature:
4 hours
Refrigerated:
72 hours
Frozen:
Unacceptable
Clinical Significance
Urine Culture has specific clinical significance and diagnostic use in identifying the presence of bacterial growth in a patient's urine. Here are key points regarding its clinical significance:
1. Identification of Urinary Tract Infections (UTIs): The primary purpose of a Urine Culture is to diagnose and confirm urinary tract infections. It helps identify the specific bacteria causing the infection, allowing for targeted treatment with appropriate antibiotics. Common bacteria associated with UTIs include Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.
2. Evaluation of Symptomatic Infections: The test is particularly valuable when a patient presents with symptoms of a urinary tract infection, such as frequent urination, burning sensation during urination, cloudy or foul-smelling urine, or lower abdominal pain. A positive culture, along with clinical symptoms, confirms the diagnosis and helps guide treatment decisions.
3. Assessment of Asymptomatic Bacteriuria: In some situations, urine culture is performed even without apparent symptoms, such as during prenatal care or prior to invasive urological procedures. Detecting asymptomatic bacteriuria is important, as it can be associated with complications in certain populations, such as pregnant women or individuals with indwelling urinary catheters.
4. Determination of Antibiotic Susceptibility: The urine culture helps identify the antibiotic susceptibility pattern of the isolated bacteria. This information is crucial for selecting the most effective antibiotic therapy and avoiding the use of broad-spectrum antibiotics when not necessary. It helps prevent the development of antibiotic resistance and ensures optimal treatment outcomes.
5. Monitoring Treatment Response: After initiating antibiotic therapy, a follow-up urine culture may be performed to assess treatment response. A negative culture indicates successful eradication of the bacteria, while persistent bacterial growth suggests treatment failure or the presence of antibiotic-resistant strains. This information helps guide further management decisions.
6. Management of Complicated Urinary Tract Infections: In complex cases, such as recurrent or persistent UTIs, urine culture provides valuable information about the presence of multiple bacterial strains, antibiotic resistance patterns, or underlying anatomical abnormalities that may contribute to the infection. This information helps guide appropriate treatment and prevent complications.
In summary, Urine Culture plays a critical role in diagnosing urinary tract infections, determining the causative bacteria, and guiding antibiotic therapy. It is useful in both symptomatic and asymptomatic cases, helping to identify the presence of infection, determine antibiotic susceptibility, monitor treatment response, and manage complicated infections. Performing urine cultures when indicated ensures appropriate and targeted treatment, reducing the risk of complications and optimizing patient care.